新辅助介入化疗在局部晚期宫颈癌治疗中的价值  

Clinical Efficacy of Neo-Adjuvant Intra-Arterial Chemotherapy for Locally Advanced Cervical Carcinoma

作　　者：宋红林[1] 黄清华[1] 李力[1] 

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科,南宁市530021

出　　处：《中国肿瘤临床》2012年第5期283-286,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨新辅助介入化疗在局部晚期宫颈癌临床治疗中的作用。方法:对87例局部晚期宫颈癌患者进行回顾性分析,根据新辅助化疗的不同途径分为新辅助介入化疗(IA-NAC)组42例和新辅助静脉化疗(Ⅳ-NAC)组45例。化疗方案为DDP(顺铂)60mg/m^2+BLM(博来霉素)25 mg/m^2+VCR(长春新碱)1 mg/m^2+MMC(丝裂霉素)10mg/m^2;或DDP 70mg/m^2+ADM(阿霉素)30 mg/m^2。化疗后根据检查决定手术或放疗。评价两组的近期和远期疗效、手术切除率、病理学变化和不良反应。结果:两组近期疗效均较好,但无显著性差异;3、5年生存率两组比较差异无统计学意义(P>0.05);Ⅱ_b期患者的手术率IA-NAC组高于Ⅳ-NAC组,IA-NAC组平均生存时间较IV-NAC组长(P<0.05)。结论:新辅助动脉介入化疗的组织缓解率、平均生存时间较静脉化疗好,但未能提高其远期生存率。Objective： The aim of the current study is to determine the clinical efficacy ofneo-adjuvant intra-arterial chemotherapy in locally advanced cervical carcinoma. Methods： From January 1997 to December 2005, 87 previously untreated patients with stage IB2-IIB cervical cancers were randomly divided into two groups： IA-NAC and IV-NAC. The drugs used in the current study included cisplatin （ 60 mg/m2 ） with mitomycin （ 10 mg/m2 ）, bleomycin （ 25 mg/m2 ）, and vincristine （ 1 mg/m2 ） or cisplatin （ 70 mg/m2 ） with doxorubicin hydrochloride （ 30 mg/m2 ） for one course. The response was assessed using pelvic and histological examinations. Results： Significant differences in the overall clinical response rate between the two groups were observed. The three- and five-year survival rates were not significantly different either. The operability of IIb stage patients was higher in IA-NAC group （ P 〈 0.05 ） compared with the IV-NAC group, and no significant differences in the mean survival time was found between the two groups （ P 〈 0.05 ）. Conclusion： Neo-adjuvant intra-arterial chemotherapy can increase the operability rate in patients with stage IIB cervical cancer and can raise the mean survival time. However, neo-adjuvant intra-arterial chemotherapy does not improve long-term survival rates compared with intravenous chemotherapy.

关 键 词：宫颈癌 新辅助化疗 动脉介入静脉化疗 

分 类 号：R737.33[医药卫生—肿瘤]